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A Weighty Issue

Pregnancy Weight Gain Guidelines

By Jennifer Lacey

The March of Dimes states if a woman begins a pregnancy underweight, she may be at risk of having a baby with a low birth weight. Further complications for an underweight mom-to-be and her developing baby may be, "dependent to some extent on the degree of low weight gain," says Dr. Pfeifer. "Inadequate weight gain increases the risk of delivery prior to 37 weeks."

Typically, most specialists will agree these women should be closely monitored throughout the course of their pregnancies. For underweight expectant women, Dr. Ellen Landsberger, assistant professor of obstetrics and gynecology and women's health at Albert Einstein College of Medicine, Bronx, N.Y., makes it a point to review her food intake with a 24-hour recall or asks her to record a detailed diary of her food intake for three days.

"We then will review her food intake together and calculate an average caloric intake," she says. "We can assess whether she is eating a healthy distribution of protein, carbohydrates and fats, all of which are important for proper growth and development of the baby. I will order an obstetrical sonogram to determine an estimated fetal weight and continue to monitor the growth of the baby to make sure the weight is average for gestational age." For women who have gained more, she also encourages her patients not to eat for two, especially early in pregnancy. "Women who do gain too much should not attempt to lose weight, however, until after delivery," she adds.

A study published in the March 2005 edition of the medical journal Obstetrics & Gynecology states women who are either underweight or overweight prior to conception are less likely than women of normal weight to report a target weight gain within the recommended guidelines set forth by the IOM when they became pregnant. The researchers of this study examined both the targeted amount of weight gain (the amount of weight the women mentioned they planned on gaining) and the amount of weight they were advised by their physicians to gain, of a group of expectant women from the San Francisco Bay area of California. The researchers of this study concluded that based on an expectant woman's pre-pregnancy BMI, overweight women were more likely to have a target gain above the IOM's guidelines, and women who were classified as being underweight were more likely to have a target gain below the guidelines.

Want to see more?

• Two of Everything, Please: Debunking the Myth of Eating for Two
• Liquid Nutrition: Smart Nutrition for Thirsty Moms
• Pregnancy Nutrition from A to Z: A Comprehensive List of Nutrition Issues for Moms-to-be
• Talk about it!